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评价化疗药安全性的指标
，但并不绝对
常用术语
7.抗生素后效应
postantibiotic
effect，PAE
细菌与抗生素短暂接触，当抗生素浓度下降，
低于MIC时，细菌生长仍受到持久抑制的效应
抑制细菌蛋白质合成的抗菌药的PAE较长
可适当延长给药间隔时间（T＞MIC+PAE）
常用术语
acquired resistance
The 'post-antibiotic' era is near, according to a report released today by the World Health Organization (WHO). The decreasing effectiveness of antibiotics and other antimicrobial agents is a global problem, and a surveillance system should be established to monitor it, the group says. There is nothing hopeful in the WHO's report, which pulls together data from 129 member states to show extensive resistance to antimicrobial agents in every region of the world. Overuse of antibiotics in agriculture — to promote livestock growth — and in hospitals quickly leads to proliferation of drug-resistant bacteria, which then spread via human travel and poor sanitation practices. ―A post-antibiotic era — in which common infections and minor injuries can kill — far from being an apocalyptic fantasy, is instead a very real possibility for the twenty-first century,‖ writes Keiji Fukuda, WHO assistant director-general for health security, in a foreword to the report. Perhaps the most worrying trend is the spread of resistance to carbapenems, the 'antibiotics of last resort', says Timothy Walsh, a medical microbiologist at Cardiff University, UK, who was an adviser for the report. ―That’s taken us by surprise,‖ he says. ―All of us are rather like rabbits in front of the headlights in how quickly this has taken off.‖ The report finds that, in some areas of the world, more than half the infections caused by one major category of bacteria — Gram-negative, which includes Escherichia coli and Klebsiella pneumoniae— involve species resistant to carbapenem drugs. There are few if any replacements for carbapenems in development, says Elizabeth Jungman, director of drug safety and innovation at the Pew Charitable Trusts in Washington DC. Companies lack economic incentives to develop new antibiotics, she says, and researchers have found it difficult to find new ways to get Gram-negative bacteria to take up antibiotics. Ultimately, the report's most surprising finding may be the lack of global data on antimicrobial resistance. ―Despite the fact we've known the potential of this going cataclysmic for ten years, as a global unit we haven't managed to get our act together,‖ says Walsh. Just 22 of the 129 WHO member states that contributed to the report had data on the nine antibiotic–bacteria pairs of greatest concern. Although the report calls for the establishment of a global monitoring network, it is unlikely that any extra money is forthcoming. ―It’s a huge problem and I'm not sure the resources are available,‖ says Keith Klugman, an epidemiologist at the Bill and Melinda Gates Foundation in Seattle, Washington. Nature doi:10.1038/nature.2014.15135
“影响”与“代谢”
耐药性
病原微生物
抗菌作用
“抗菌”与“耐药”
抗微生物药
第１节 常用术语
1.抗菌谱：抗菌药物的抗菌范围
Antibacterial
spectrum 广谱:
窄谱:
仅对单一菌种或
对多类细菌有效，
单一菌属有抗菌作用。 甚至包括非细菌病原微生物。
如：异烟肼等
如：四环素等
常用术语
2.最低抑菌浓度
8.首次接触效应
First
exposure effect ， FEE
抗菌药物在初次接触细菌时有强大的抗菌效应，
再度接触或连续与细菌接触，并不明显地增强 或再度出现这种明显的效应，需要间隔相当时 间（数小时）以后，才会再起作用。
第2节 抗菌药物的作用机制
干扰病原体生化代谢，影响其结构和功能 理想靶点：病原体特有，为其生长代谢所必需
用至今。1980年代力主推动中国病毒学研
究进入分子生物学时代。
入侵机体的病原体及化学治疗
微生物 寄生虫
肿瘤 细胞
化学治疗（chemotherapy， 化疗）：对病原体， 包括微生物、寄生虫、肿瘤细胞采用化学药物的治疗
杀灭或抑制作用
化学治疗药物
chemotherapeutic drugs
化学治疗药物分类
他们更应被铭记---
王岳 （1915-1985），福建福州人，著
朱既明 （1917-1998），江苏宜兴人， 著名病毒学家，中科院院士。1945年采用 我国自己分离的菌种研制青霉素成功。 1963年研制成功高度减毒麻疹活疫苗 ，沿
名微生物学家，中科院院士。1966年，
从小单胞菌中分离到庆大霉素的产生菌 ， 并在1969年正式投产，是我国抗生素事 业的创始人之一 。 1983年 ，找到新型免 疫抑制剂——环孢菌素的产生菌。
1.抑制细菌细胞壁的合成
2.改变细菌胞浆膜通透性 3.抑制细菌蛋白质合成 4.影响细菌核酸代谢 5.影响细菌叶酸代谢
第3节 细菌耐药性
又称抗药性
bacterial resistance
细菌对抗生素不敏感的现象，是细菌在自身生存过程中的Βιβλιοθήκη 种特殊保护形式分类
固有耐药性 获得耐药性
intrinsic resistance
此ppt下载后可自行编辑
微生物感染的 药物治疗
抗菌药物的辉煌发展史
20世纪30年代，磺胺类药物问世
开创了化学治疗的新纪元 细菌性传染疾病得到控制
SD
G. Domagk （1895-1964 ），1939
SMZ
Sir A. Fleming （1881-1955 ），1945
S. A. Waksman （1888-1973 ），1952
minimal
inhibitory concentration，MIC
3.最低杀菌浓度
minimal
bactericidal concentration，MBC
评价抗菌活性
制定给药方案 判断细菌耐药 体外实验，影响因素多
常用术语
4.抑菌药
具有抑制细菌生长繁殖而无杀灭细菌作用的抗
抗微生物药 细菌、放线菌、 支原体、衣原体、 立克次体、螺旋体、 真菌、病毒 抗真菌药 抗菌药 合成抗菌药 抗生素
